What is the role of postprandial glucose measurements in the management of type 2 diabetes mellitus (DM)?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Glycemic control is a function not only of fasting and preprandial glucose values but also of postprandial glycemic excursions. Emphasis on postprandial glucose measurements has been fueled to some degree by the availability of short-acting insulin secretagogues, very-short-acting insulin, and alpha-glucosidase inhibitors, all of which target postprandial glycemia.

While postprandial glucose levels are a better predictor of macrovascular disease risk early in the course of loss of glucose tolerance, it remains to be seen whether targeting after-meal glucose excursions has a greater effect on the risk of complications than do more conventional strategies. A study by Siegelaar et al seriously questions the notion that targeting postprandial glucose variability favorably affects cardiovascular outcomes in patients after myocardial infarction. [244] Clearly, more studies are needed.


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